Articles: chronic-pain.
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Curr Opin Support Palliat Care · Jun 2012
ReviewKetamine for chronic noncancer pain: concerns regarding toxicity.
Ketamine misuse and abuse is on the increase. This review focuses on recent studies on ketamine toxicity in recreational users and possible implications for the use of ketamine in chronic pain therapy. ⋯ These findings may have implications for the clinical use of ketamine in chronic noncancer pain conditions. Until safety issues are resolved, it is suggested that chronic pain treatment involving higher doses and repeated exposure to ketamine be restricted to the context of randomized, controlled trials or clinical audits.
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Randomized Controlled Trial
Effect of core stability exercises on feed-forward activation of deep abdominal muscles in chronic low back pain: a randomized controlled trial.
A randomized controlled trial. ⋯ Abdominal muscle onset was largely unaffected by 8 weeks of exercises in chronic LBP patients. There was no association between change in onset and LBP. Large individual variations in activation pattern of the deep abdominal muscles may justify exploration of differential effects in subgroups of LBP.
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Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. This article contains a brief description of disc disease in young adults resulting in chronic low back pain. Topics including causes of early degeneration of disc, therapies, and suggestions for strengthening the discs are discussed.
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Review
Chronic pain in the elderly with advanced dementia. Are we doing our best for their suffering?
Elderly subjects with advanced dementia are exposed, like all aging individuals, to a wide range of chronic degenerative and progressive medical conditions which can cause pain and discomfort, both physical and psychological. Pain is defined as an unpleasant subjective experience, generally assessed with verbal self-reporting methods. The inability to report pain verbally - a common occurrence in advanced stages of dementia - is widely recognized as the main confounding factor in identifying these patients' pain. ⋯ Although some currently available tools for pain assessment in non-verbal older adults seem promising, no single tool has yet been sufficiently validated as reliable for widespread adoption in clinical practice. Prior research has documented a significantly lower prescription of analgesic medications in demented patients than in cognitively intact peers: as untreated or under-treated pain can have adverse physical and psychological consequences, there is an urgent need for appropriate pain assessment methods in elderly patients with advanced dementia, since too many of them continue to suffer needlessly. The purpose of this review is to discuss the main tools developed in the last decade for pain assessment in non-communicative older individuals, highlighting the strengths and weaknesses of each, and providing a guide for their use in clinical practice, particularly in geriatric settings.
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The Journal of urology · Jun 2012
Polysymptomatic, polysyndromic presentation of patients with urological chronic pelvic pain syndrome.
Somatization disorder has been described in several comorbid functional syndromes of urological chronic pelvic pain syndrome, such as irritable bowel syndrome. We investigated whether a subset of patients with urological chronic pelvic pain syndrome may have the polysymptomatic, polysyndromic presentation pattern that is common in somatization disorder. ⋯ A subset of female patients with urological chronic pelvic pain syndrome endorses numerous extrapelvic symptoms across multiple organ systems. The checklist may be valuable to assess patients for this polysymptomatic, polysyndromic symptom pattern, which is common in somatization disorder. Recognizing this polysymptomatic, polysyndromic presentation will prompt clinicians to investigate further to determine whether somatization disorder may be an underlying diagnosis in a small subset of patients with urological chronic pelvic pain syndrome who complain of numerous extrapelvic symptoms.